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Sökning: WFRF:(Trimpou Penelope 1973)

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  • Demeke, T., et al. (författare)
  • Comorbidity and health-related quality of life in Somali women living in Sweden
  • 2019
  • Ingår i: Scandinavian Journal of Primary Health Care. - 0281-3432 .- 1502-7724. ; 37:2, s. 174-181
  • Tidskriftsartikel (refereegranskat)abstract
    • - Objective: To explore the relationship between low serum vitamin D levels and comorbidity in Somali women, immigrants to Sweden. Design and setting: Cohort study in a Primary Health Care Center and a University Hospital. Subjects: Somali women skin type V, n = 114, aged 18–56 years, from latitude 0–10 ○ N, living in Sweden, latitude 57 ○ N > 2 years were compared with women from a population sample, skin type II-III, n = 69, aged 38–56 years, the WHO MONICA study, Gothenburg, Sweden. Main outcome measures: Serum (S)-25(OH)D, S-parathyroid hormone (PTH), comorbidity and Health-Related Quality of Life (HRQoL) using the Short Form-36 (SF-36) and part of the EQ-5D questionnaires. All calculations were corrected for age. Results: Vitamin D deficiency (S-25(OH)D < 25 nmol/l) was found in 73% of the Somali women and in 1% of the controls (p <.0001). S-PTH was elevated (>6.9 pmol/l) in 26% and 9%, respectively (p <.004). Somali women used less medication, 16% vs. 55%, p <.0001) but more allergy medication, 11% vs. 7% (p =.006), had fewer fractures, 2% vs. 28% (p <.0001) and lower HRQoL in 7 out of 9 scales (p <.05–.001), than native controls. There were no differences in the prevalence of diabetes mellitus, hypothyroidism, positive thyroid peroxidase antibodies, vitamin B12 deficiency, celiac disease or hypertension. Conclusions: Vitamin D deficiency was common in Somali women living in Sweden, 73%, but comorbidity was low. Both mental, and especially physical HRQoL scores were lower in the Somali women. The effects of long-lasting deficiency are unknown.Key points The aim was to explore the relationship between vitamin D deficiency (S-25(OH)D < 25 nmol/l) and comorbidity in immigrants. Vitamin D deficiency was common in Somali women living in Sweden, 73%, but comorbidity of hypothyroidism, diabetes mellitus, hypertension, fractures and use of medications was low. Both mental, and especially physical, Health-Related Quality of Life were lower in the Somali women than in native Swedish women. The effects of long-lasting deficiency are unknown. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
  • Einarsdottir, Margret, et al. (författare)
  • High prescription rate of oral glucocorticoids in children and adults: a retrospective cohort study from Western Sweden.
  • 2020
  • Ingår i: Clinical endocrinology. - 1365-2265. ; 92:1, s. 21-28
  • Tidskriftsartikel (refereegranskat)abstract
    • Glucocorticoids (GCs) are a cornerstone in treating various common and uncommon diseases. The aim of this study was to estimate the prevalence of GC use in terms of doses associated with risk of tertiary adrenal insufficiency in adults and children, and treatment indications.This was a retrospective cohort study. Information on dispensed prescriptions was obtained from the Swedish Prescribed Drug Register. Patients with prescriptions of prednisolone (or equivalent dose of other GCs) ≥5 mg daily for ≥21 days between 2007-2014 were included. Information on concurrent diseases was obtained from the Swedish National Patient Register and the Västra Götaland Regional Healthcare Database.Of 1,585,335 inhabitants in Västra Götaland County, 223,211 were included in the study (women 55.6%). Mean age was 48 ± 24 years. Period prevalence of oral GC use during the 8-year study period was 14.1%. The highest prevalence (27.4%) was in men aged 80-89 years and lowest (7.5%) in men 10-19 years of age. The period prevalence in children 0-9 years of age was 10.6%. COPD and asthma were the most common indications for treatment (17.2%) followed by allergy (12.5%), and malignant neoplasms (11.5%). Allergy was the most frequent indication (20.5%) in children and adolescents.Between 2007-2014, every seventh inhabitant in western Sweden received a GC prescription at doses associated with risk of developing tertiary adrenal insufficiency. These findings illustrate the importance of awareness of the potential development of tertiary adrenal insufficiency in both pediatric and adult patients.
  • Esposito, Daniela, et al. (författare)
  • Pituitary dysfunction in granulomatosis with polyangiitis
  • 2017
  • Ingår i: Pituitary. - 1386-341X. ; 20:5, s. 594-601
  • Tidskriftsartikel (refereegranskat)abstract
    • Granulomatosis with polyangiitis (GPA) is a multisystem disease, characterized by necrotizing small-vessel vasculitis, which mainly affects the respiratory tract and the kidneys. Pituitary involvement in GPA is rare, present in about 1% of all cases of GPA. To date, only case reports or small case series have been published. Herein we report clinical features, imaging findings, treatment and outcomes in three patients with GPA-related pituitary dysfunction (PD). A retrospective analysis of three cases of GPA-related PD was conducted, followed by systematic review of the English medical literature using PubMed. The three cases include three women aged between 32 and 37 years. PD was the presenting feature in one and two developed PD in the course of the disease. All patients had a pituitary lesion on MRI. Conventional treatment with high doses of glucocorticoids and cyclophosphamide led to resolution or improvement of the MRI abnormalities, whereas it was not effective in restoring PD. A systematic review identified 51 additional patients, showing that GPA can lead to partial or global PD, either at onset or, during the course of the disease. Secondary hypogonadism is the predominant manifestation, followed by diabetes insipidus (DI). Sellar mass with central cystic lesion is the most frequent radiological finding. GPA should be carefully considered in patients with a sellar mass and unusual clinical presentation with DI and systemic disease. Although conventional induction-remission treatment improves systemic symptoms and radiological pituitary abnormalities, hormonal deficiencies persist in most of the patients. Therefore, follow-up should include both imaging and pituitary function assessment.
  • Forslund, Maria, 1978, et al. (författare)
  • Higher menopausal age but no differences in parity in women with polycystic ovary syndrome compared with controls.
  • 2019
  • Ingår i: Acta obstetricia et gynecologica Scandinavica. - 1600-0412. ; 98:3, s. 320-326
  • Tidskriftsartikel (refereegranskat)abstract
    • To address the question of whether women with polycystic ovary syndrome (PCOS) reach menopause later than age-matched controls, we conducted a follow-up cohort study of women with well-characterized PCOS that was diagnosed 24 years ago. The hypothesis was that women with PCOS would reach menopause later than non-PCOS women. Parity during these 24 years was also studied.Twenty-seven women diagnosed with PCOS in 1992 (mean age 29.5 years) were re-examined in 2016 (mean age 52.4 years). Randomly selected women, n = 94 (mean age 52.4 years), from the same geographic area included in the World Health Organization MONICA study, Gothenburg, Sweden, served as controls.The mean menopausal age in women with PCOS was higher than in controls (53.3 ± 2.2 years vs 49.3 ± 3.5 years, P < 0.01). Serum-follicle stimulating hormone levels were lower in the PCOS women than in controls (31.0 ± 28.1 IU/L vs 52.3 ± 37.7 IU/L, P = 0.01). There was no difference in parity between women with PCOS (1.9 ± 1.3 children, range 0-4) and controls (1.7 ± 1.0, range 0-4 children).Women with PCOS reached menopause 4 years later and had lower serum-follicle stimulating hormone compared with age-matched controls. Neither parity nor nulliparity differed between women with PCOS and controls.
  • Forslund, Maria, 1978, et al. (författare)
  • Type 2 diabetes mellitus in women with polycystic ovary syndrome during a 24-year period: importance of obesity and abdominal fat distribution.
  • 2020
  • Ingår i: Human reproduction open. - 2399-3529. ; 2020:1
  • Tidskriftsartikel (refereegranskat)abstract
    • What are the predictive factors for later development of type 2 diabetes (T2DM) in women with polycystic ovary syndrome (PCOS)?Obesity and abdominal fat distribution in women with PCOS in the mid-fertile years were the major risk factors for T2DM development 24 years later when lifestyle factors were similar to controls.Women with PCOS have an increased prevalence of T2DM.A longitudinal and cross-sectional study was performed. Women with PCOS were examined in 1992 and in 2016. Randomly selected, age-matched women from the general population served as controls.Women with PCOS (n = 27), attending an outpatient clinical at a tertiary care centre for infertility or hirsutism were diagnosed in 1992 (mean age 30 years) and re-examined in 2016 (mean age 52 years). Women from the World Health Organization MONItoring of trends and determinants for CArdiovascular disease (WHO MONICA-GOT) 2008, aged 38-68 years, served as controls (n = 94), and they were previously examined in 1995. At both at baseline and at follow-up, women had blood samples taken, underwent a clinical examination and completed structured questionnaires, and the women with PCOS also underwent a glucose clamp test at baseline.None of women with PCOS had T2DM at baseline. At the 24-year follow-up, 19% of women with PCOS had T2DM versus 1% of controls (P < 0.01). All women with PCOS who developed T2DM were obese and had waist-hip ratio (WHR) >0.85 at baseline. No difference was seen between women with PCOS and controls regarding use of high-fat diet, Mediterranean diet or amount of physical activity at follow-up at peri/postmenopausal age. However, women with PCOS had a lower usage of a high-sugar diet as compared to controls (P = 0.01). The mean increases in BMI and WHR per year were similar in women with PCOS and controls during the follow-up period.The small sample size of women with PCOS and the fact that they were recruited due to infertility or hirsutism make generalization to women with milder forms of PCOS uncertain.Obesity and abdominal fat distribution, but not hyperandrogenism per se, in women with PCOS in the mid-fertile years were the major risk factors for T2DM development 24 years later when peri/postmenopausal. Lifestyle factors were similar to controls at that time.The study was financed by grants from the Swedish state under the agreement between the Swedish government and the country councils, the ALF-agreement (ALFGBG-718611), the Gothenburg Medical Association GLS 694291 and 780821, the Swedish Heart Lung Foundation and Hjalmar Svensson Foundation. The authors have no conflict of interest.
  • Kontogeorgos, Georgios, et al. (författare)
  • Normocalcaemic, vitamin D-sufficient hyperparathyroidism - high prevalence and low morbidity in the general population: A long-term follow-up study, the WHO MONICA project, Gothenburg, Sweden
  • 2015
  • Ingår i: Clinical Endocrinology. - 0300-0664. ; 83:2, s. 277-284
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectiveThere is limited knowledge about the natural history of normocalcaemic, vitamin D-sufficient hyperparathyroidism (nHPT). The aim was to study the prevalence of nHPT and its relation to morbidity. DesignCross-sectional and retrospective study at the Sahlgrenska University Hospital, Gothenburg, Sweden. SubjectsA random population of 608 men and women, age 25-64years, was studied in 1995 as part of the WHO MONICA study and reinvestigated in 2008 (n=410, of whom 277 were vitamin D sufficient). MeasurementsA serum intact parathyroid hormone (S-PTH) 60ng/l was considered as HPT, S-calcium 215-249mmol/l as normocalcaemia and S-25(OH)D50nmol/l as vitamin D sufficiency. Data on fractures, stroke and myocardial infarction were retrieved until 2013, that is a 17-year follow-up. ResultsThe prevalence of nHPT was 20% in 1995 (age 25-64) and 110% in 2008 (age 38-79). S-PTH was positively correlated with age and BMI. After adjustment for these variables, a high S-PTH level (60ng/l) at follow-up was associated with previously low S-25(OH)D, high osteocalcin, S-PTH and both past and presently treated hypertension. No relation was seen with creatinine, cystatin C, malabsorption markers, thyroid function, glucose, insulin, lipids, calcaneal quantitative ultrasound, fractures, myocardial infarction, stroke or death at follow-up. ConclusionsThis small random population study showed that nHPT was common, 11% at follow-up. Only one individual developed mild hypercalcaemia in 13years. Previous S-PTH was predictive of nHPT and hypertension was prevalent, but no increase in hard end-points was seen over a 17-year period.
  • Kousoula, Konstantina, et al. (författare)
  • The impact of adjustments to the diagnostic criteria for biochemical remission in surgically treated patients with acromegaly
  • 2017
  • Ingår i: Growth Hormone and IGF Research. - 1096-6374. ; 36, s. 16-21
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The suggested criteria for biochemical remission in patients treated for acromegaly were recently modified. The aim of this project was to study to what extent this modification influences remission rates. Design, patients and methods This was a retrospective study of 55 consecutive patients [29 men; median age 47 years (interquartile range 38–68)] diagnosed with acromegaly between 2003 and 2014. After treatment serum IGF-I and/or GH was measured according to a standardized protocol. The biochemical remission status was defined according to the clinical guidelines from 2010 and2014. Results Out of 55 patients, 44 patients were primarily operated. Of these, 33 (75%) were evaluated 3–12 months postoperatively by measuring serum IGF-I and GH during an oral glucose tolerance test. According to the 2010 guidelines, 11 patients (33%) were in biochemical remission, 15 patients (46%) were not and 7 patients (21%) had discordant results (normal IGF-I and high GH or vice versa). Applying the 2014 guidelines in the same group, 16 patients (49%) were in biochemical remission, 7 patients (21%) were not and 10 patients (30%) had discordant results. Thus, by using the most recent criteria for biochemical control, more patients were considered to be in remission, or with discordant results, and fewer patients not in remission (P < 0.05). Conclusion An apparently minor adjustment of the criteria for biochemical control has a significant impact on remission status in patients treated for acromegaly, eventually affecting follow-up and treatment strategies. © 2017 Elsevier Ltd
  • Krantz, Emily, et al. (författare)
  • Comparison between different instruments for measuring health-related quality of life in a population sample, the WHO MONICA Project, Gothenburg, Sweden: an observational, cross-sectional study.
  • 2019
  • Ingår i: BMJ open. - 2044-6055. ; 9:4
  • Tidskriftsartikel (refereegranskat)abstract
    • The general aim was to meet the need for empirical comparative studies of health-related quality of life (HRQoL) assessment instruments, by evaluating and comparing the psychometric properties and results of three different, widely used, generic HRQoL instruments in a population sample. The specific aims were to evaluate the subscales of the different instruments that measure the same domain and to assess the association between the HRQoL measures and a single-item self-rated health scale.An observational cross-sectional study.A population-based sample from Gothenburg, Sweden, was studied in 2008 in the WHO MONItoring of trends and determinants for CArdiovascular disease.A total of 414 subjects were included, 77% women, age range 39-78 years.The Nottingham Health Profile (NHP), the Short Form-36 questionnaire (SF-36), the Psychological General Well-Being Index (PGWB) and a self-rated health scale were used.Scores were analysed for their psychometric properties, internal consistency (Cronbach's α), construct validity (Spearman's rank correlations and R2 coefficients) and discriminative ability for the presence of self-rated ill-health.PGWB and SF-36 had higher Cronbach's α scores than NHP. All correlations calculated between the subscales that were conceptually similar were significant (p<0.01). All subscales could differentiate the presence of self-rated ill-health according to the self-rated health scale (p<0.001). The self-rated health scale correlated strongly with all of the three HRQoL instruments used.There was a high concordance between the instruments within each domain that was conceptually similar. All three HRQoL instruments (PGWB, SF-36 and NHP) could discriminate the presence of self-rated ill-health. The simple and quick self-rated health scale correlated strongly with the more time-consuming PGWB, SF-36 and NHP. The result supports the existence of a strong association between the self-rated health scale and HRQoL in the general population.
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